Joseph V. Henderson, MD

Joseph V. Henderson, MD

Professor, Community and Family Medicine; Director, Interactive Media Laboratory

Dr. Joseph Henderson brings an extraordinarily broad background to his work as a medical educator and developer of educational technology applications. His early neurophysiology research has provided a foundation for rigorous thinking, and for considering and applying various theories of learning. His work in computer-aided diagnosis for the U. S. Navy provided experience in computer technology and informatics, producing video training materials, and use of simulated/standardized patients for training and evaluation. During his graduate work in epidemiology, Dr. Henderson combined multivariate categorical analyses and interactive statistical graphics to provide a novel interface to a multimedia data set (text, images, audio) dealing with Vietnam War trauma. This was an exploration of methods of combining rigorous, quantitative approaches to data analysis and display, with more qualitative, narrative-based representations of what is being studied; the system demonstrated how an investigator could use the scientific power of reductionism while retaining rich, contextual information that is less amenable to abstraction.

Dr. Henderson has continued this last theme in most of his subsequent educational research and development work. In creating numerous technology-based learning programs for professionals and patients he has strived to present quantitative, scientific-technical information in the context of complex, qualitative (usually psychosocial) factors that can influence health outcomes. For example, the series of Shared Decision Programs developed for the Foundation for Informed Medical Decision Making presented scientific and quantitative information (e.g., how metastasis occurs, risk of recurrence) along with interviews with patients who tell their stories, explain their reasons, and recount their experiences and reactions. In this way the patient may achieve a deeper understanding of the factors influencing outcomes, including their own values.

Dr. Henderson has also taken this approach with his professional education programs. This work has culminated in the development and application of a model for technology-based learning termed the "Virtual Practicum." The model seeks to resolve the rigor vs. relevance dilemma posed by Donald Schön: most medical education focuses on the high ground of "manageable problems [that] lend themselves to solution through the application of research-based theory and technique" and not preparing students to work in the swamp of "messy, confusing problems [that] defy technical solution." Another way of expressing Schön's concern is that educators in medicine and public health tend to ignore the transactional nature of practice, i.e., the psychosocial aspects in which the highly variable nature of human behavior and human situations plays a significant role. Management of HIV/AIDS is such an area. Scientific understanding of HIV disease is exceptional, and technical methods for its management are proliferating rapidly. However, care is often compromised by behavioral factors-ranging from prevention of transmission to persistence in taking complicated drug regimens-that require knowledge and skills that, as Schön says, "lie beyond the canons" of technical rationality. It is in these indeterminate zones of practice that we find well-developed scientific and technical knowledge, balanced with empathy, intuition, and artistry that mark the exceptional practitioner. Dr. Henderson sees the application of emerging communication technologies as providing a new opportunity to consider how we might better prepare students to develop these various forms of knowledge. The Virtual Practicum model provides the learner with a variety of learning experiences that impart scientific and technical knowledge, while retaining much of the rich, psychosocial, human context that comprises Schön's swamp.

Reaction of students, practitioners, and educators to the virtual practicum model has been uniformly positive and enthusiastic. It is likely that wide adoption of the model and its attendant methods will positively affect professional education in medicine and public health and, at the same time, stimulate the development of new concepts, models, and methods for technology-based learning. However, there are significant barriers: the lack of a sufficient number of programs based on it, the costs of program development, and the lack of a community of educator/developers with requisite knowledge and skills in multimedia design and production and network technology. Dr. Henderson is currently developing a plan and methods to reduce these barriers; he sees this as a major new thrust for his research and development efforts.

The other major research and development area is in educational technology per se. With support from the Defense Advanced Projects Agency and the National Science Foundation, Dr. Henderson's group examined the use of current- and next-generation (broadband) networks for distance learning. More recent work includes training of public health professionals in a project funded by the Centers for Disease Control and Prevention and a project funded by the Office of Domestic Preparedness at the Department of Homeland Security, dealing with counterterrorism preparedness and training.